- WMCHealth (Valhalla, NY)
- …including Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage, ... the portion of the cost which is reimbursable and establishing methods for follow-up on all third party billing. Supervision may be exercised over lower level clerical support staff. Does related work as required. Examples of Work: (Illustrative Only)… more
- FlexStaff (Bronx, NY)
- …cleared for communicable diseases and up-to-date immunizations. + Medicaid and Medicare Provider IDs in good standing. + Bilingual preferred Additional Salary ... Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as ... MSHP's subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary… more
- Robert Half Accountemps (Albany, NY)
- …representatives from commercial insurers and entitlement programs (eg, Medicaid/ Medicare ) to complete credentialing requirements. + Prepare credentialing packets, ... provide documentation checklists, and schedule credentialing meetings as needed (in-person or virtual). + Complete credentialing and re-credentialing applications for commercial payers and government programs. + File appropriate rosters with facility-based… more
- Cognizant (Albany, NY)
- …UB/institutional (CMS-1450) and/or professional (CMS 1500) claims. + Knowledge of Medicare /Medicaid payment and coverage guidelines and regulations. + Must be able ... to work with minimal supervision. + 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability… more
- Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
- …to detail, and exercise professional work ethics. + Familiarity with applicable Medicare and Medicaid programs preferred. + Understanding of HIPAA, Privacy, Safety, ... and Compliance guidelines. + Knowledge of Transition of Care procedures and processes preferred. + Intermediate understanding and ability to navigate a database system. + Intermediate understanding of Microsoft Office Suite (Excel, Word, etc.) and knowledge of… more
- Molina Healthcare (Syracuse, NY)
- …type management responsibility. 5 years progressive experience supporting a Medicaid,. Medicare and Marketplace or large claims processing environment with ... multi-functional work units and tasks. Experience in Salesforce, EvolveNxt, SAP, Genesys Experience System Migrations **Preferred Experience** 6 - 8 years working in a claims processing system. Health care environment experience. To all current Molina… more
- New York State Civil Service (Bronx, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists. If appointed and subsequently listed as an excluded individual or ... entity on any of these lists, you may be terminated from your employment.4. If appointed, the selected candidate must establish and maintain residency in New York State to continue employment in this position.Plus location pay of $4,000.#LI-DNI Some positions… more
- Elderwood (Buffalo, NY)
- …Days - 8:00am - 4:00pm #Talroo Responsibilities + Electronic billing of Medicare , Medicaid and Third Party Insurance pharmacy claims utilizing Framework LTC Pharmacy ... system. + Skilled nursing facility, assisted living facility and private pay pharmacy claim billing + Troubleshoot rejected insurance claims resulting in payments + Prior Authorizations required from Third Party Insurance + Bill/Invoice Review + Medicaid… more